MEDICARE: DR. SUSAN MARIE CAMPEAU DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2948	NC

General Provider Information

NPI Number	:	1407814841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN MARIE CAMPEAU DC

Provider Business Mailing Address
First Line	:	PO BOX 1074
Second Line	:
City	:	SILER CITY
State	:	NC
Zip	:	27344-1074
Country	:	US
Telephone Number	:	919-742-5306
Fax Number	:	919-742-5306

Provider Business Practice Location Address
First Line	:	110 VILLAGE LAKE RD
Second Line	:	SUITE C
City	:	SILER CITY
State	:	NC
Zip	:	27344-1821
Country	:	US
Telephone Number	:	919-742-5306
Fax Number	:	919-742-5306

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	02/27/2008

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